Relationship between menstrual cycle dysfunction in epileptic women and antiepileptic drugs

Abstract

  Objective: Menstrual cycle dysfunction (MCD) in epileptic women with mental retardation (MR) and basic disorders has scarcely been reported. To determine the occurrence of MCD in these women, relationship between MCD and antiepileptic drugs (AED) and taking measures to meet the situation, we analyzed epileptic women following up in our center. Methods: Twenty-nine postmenarcheal women included in the study. These included 23 patients with focal onset seizures and six with generalized onset seizures. Ages at examination and seizure onset were 28.7 and 5.9 years on average, respectively. Mental retardation was found in 22 patients and 15 had basic disorders. Results: MCD was found in 10 patients and 19 patients had normal menstrual cycles. All seven patients without MR showed normal menstrual cycles. Among nine patients prescribed valproate (VPA), three patients showed MCD. One of them had polycystic ovaries and substitution of lamotrigine for VPA normalized her menstrual cycles, resulting in good seizure control. Among 21 patients treated with the liver enzyme-inducing AEDs, fifteen patients exhibited normal menstrual cycles, while six patients showed MCD. Among them, hormonal examinations were performed in four patients and one patient showed low serum cortisol levels. In this patient, one of her AEDs was discontinued without seizure relapse and administration of cortisol alleviated the MCD. Conclusions: The frequency of MCD in this study was higher than that of previous reports, presumably due to many patients showing MR and basic disorders. In patients with MCD, a change or the discontinuation of AEDs normalized her menstrual cycles, resulting in good seizure control.